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Second Trimester Basics

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Learn what to expect during the second trimester of pregnancy.

by Dr. Peter J. D'Adamo with Catherine Whitney

As you enter your second trimester, your pregnancy begins to show. The chance of miscarriage is substantially lessened, and you may begin to relax as some of the more uncomfortable symptoms  morning sickness, constipation, fatigue  begin to disappear.

During the second trimester you should gain about 1 pound a week  for a total of 12 to 14 pounds. You may experience a greater appetite, especially if you no longer suffer from nausea. Monitor your weight, and, if needed, increase your calorie intake by 100 to 300 calories a day.

Fetal growth is rapid during the second trimester, and you'll experience a number of physiological changes related to that growth. As your blood volume increases to pump more nutrients to your fetus, you may find yourself more susceptible to nosebleeds and bleeding gums due to extra pressure on these sensitive membranes. You'll also be more vulnerable to conditions that can be dangerous to the health of your fetus if they are not kept in check.

Common Second Trimester ConditionsAllergies If you are susceptible to allergies, they may be exacerbated during this time by hyperimmunity  the increased vigilance of your immune system designed to protect your fetus.

Bleeding Gums/Nosebleeds High levels of reproductive hormones circulating in your body increase blood flow to the delicate mucus membranes of the nose and mouth. This can bring easy bleeding when you stress these areas  by brushing your teeth too vigorously or by blowing your nose too hard. If you have allergies, a runny nose can make the problem worse.

Blood Sugar Imbalance Most pregnant women have more sugar (glucose) in their blood during the second trimester. This is normal, since your fetus requires more nourishment. However, elevated blood sugar can lead to a dangerous condition called gestational diabetes, which can cause premature birth and even birth defects.

Hemorrhoids and Varicose Veins These are inflammatory conditions. Hemorrhoids are actually varicose veins of the anus.

Exercise Guidelines As your pregnancy progresses, the extra weight and its unwieldy distribution place stress on your joints and muscles, especially in the lower back and pelvis. You might also have problems with circulation, causing leg cramps and dizziness. Adapt your exercise regimen accordingly. If you are still engaging in rigorous workouts, such as cycling or step exercises, this would be a good time to shift to less strenuous activities  and those that don't require careful balance. As your fetus has grown, your center of gravity has shifted. You also may have less oxygen available, so reduce the pace of your routines, or stop altogether if you become breathless.

After the first trimester, avoid exercises that require lying flat on your back. The weight of your expanding uterus can compress major blood vessels and restrict circulation. Do your abdominal exercises in a standing position, and other floor exercises lying on your side.

Overheating during exercise can be dangerous. Keep your body temperature at a moderate level. An increase of more than one degree of body heat can be dangerous. If you're not sure, wear a monitor.

When Not To Exercise

You have pregnancy-induced high blood pressure

You have asthma

You experience bleeding during the second trimester

You have a history of late miscarriage

Do Your Kegels Kegel exercises should be a part of your daily routine, beginning in the second trimester. During the last months of pregnancy the growing fetus puts pressure on your bladder, which makes you feel the need to urinate frequently. Sometimes women limit their fluids when this happens, but it's absolutely essential that you keep your fluid intake high to stay hydrated. A better solution: Kegel exercises to strengthen the muscles around your urethra. Here's how: Contract the muscles in your vagina, urethra, and anus  as if you were trying to hold back urine. Hold for 5 to 7 seconds, then release. Repeat 10 to 20 times a day.

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